A STUDY OF EFFICACY OF NITROFURANTOIN AND FOSFOMYCIN IN E. COLI URINARY TRACT INFECTION

Abstract

Objective: To compare the efficacy of Nitrofurantoin and Fosfomycin in the treatment of Urinary Tract Infection (UTI) caused by Escherichia coli in adult patients. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Medicine, Khyber Teaching Hospital, Peshawar, from January 2023 to June 2023. Patients and Methods: A total of 120 adult patients with clinically and laboratory confirmed E. coli UTI were included through non-probability consecutive sampling. Patients were randomly allocated into two groups. Group A received cefixime 400 mg/day orally for 5 days, while Group B received amoxicillin–clavulanate 625 mg orally three times daily for 5 days. Efficacy was defined as resolution of fever and dysuria, and less than 10 WBCs/HPF on urinalysis at day 5. Results: Out of 120 patients, 60 in each group, the mean age was 36.5 ± 10.2 years. Females constituted 70% of cases. Efficacy was observed in 49 patients (81.7%) in the cefixime group compared to 37 patients (61.7%) in the amoxicillin–clavulanate group (p=0.018). Conclusion: Oral cefixime demonstrated higher efficacy compared to amoxicillin–clavulanate in the treatment of E. coli UTIs. It may be considered a preferred empirical oral antibiotic in such cases, while antibiotic stewardship and culture-guided therapy should continue to guide prescribing. 

Keywords: Urinary tract infection, E. coli, Cefixime, Amoxicillin–clavulanate, Antibiotic efficacy.